医疗团队资源管理模式在急性缺血性脑卒中患者中的应用

Application of medical team resource management mode in patients with acute ischemic stroke

目的探讨在急性缺血性脑卒中(AIS)患者急救绿色通道中采取医疗团队资源管理模式的作用。方法回顾性分析许昌市中心医院2020年1月至2022年2月收治的72例AIS患者的临床资料。2020年1月至2021年1月急诊科采取常规急救绿色通道期间收治的AIS患者36例作为对照组[女17例,男19例,年龄(60.56±3.89)岁];2021年2月至2022年2月急诊科采取医疗团队资源管理模式期间收治的AIS患者36例作为观察组[女16例,男20例,年龄(60.59±3.91)岁]。比较两组急救效率、神经功能、日常生活能力、致残率、生活质量以及患者满意度。采用t检验、χ^(2)检验进行统计比较。结果观察组急诊分诊时间为(3.68±1.15)min、急诊滞留时间为(39.42±3.18)min、就诊至溶栓时间为(55.23±5.40)min,均高于对照组的[(5.09±1.23)min、(46.24±3.25)min、(64.79±5.53)min](t=5.024、8.999、7.421,均P<0.001);观察组出院时美国国立卫生研究院卒中量表(NIHSS)评分为(6.51±1.50)分、日常生活能力量表(ADL)评分为(21.35±2.16)分,均低于对照组[(8.93±1.54)分、(25.50±2.19)分](t=6.754、8.095,P<0.001);观察组致残率为2.78%(1/36),低于对照组的16.67%(6/36)(χ^(2)=3.956,P=0.047);观察组出院时脑卒中生活质量量表(SS-QOL)评分为(140.84±6.83)分,高于对照组的(119.92±6.64)分(t=13.177,P<0.001);观察组患者满意度中急救方式为(21.26±1.18)分、安全管理为(21.85±1.23)分、人文关怀为(21.96±1.25)分、护理态度为(21.80±1.43)分、总分为(84.43±3.34)分,均高于对照组[(18.98±1.13)分、(19.94±1.20)分、(18.54±1.16)分、(19.06±1.30)分、(75.54±3.26)分](t=8.373、6.669、12.033、8.507、11.429,均P<0.001)。结论AIS患者急救绿色通道中采取医疗团队资源管理模式,可提升急救效率,改善患者神经功能,促进其日常生活能力提升,有效改善预后,从而提升患者满意度。

Objective To explore the effect of adopting the medical team resource management mode in first aid green channel for patients with acute ischemic stroke(AIS).Methods A retrospective study was conducted on the clinical data of 72 patients with AIS admitted to Xuchang Central Hospital from January 2020 to February 2022.The 36 patients who took the routine first aid green channel at the emergency from January 2020 to January 2021 were set as a control group,including 17 females and 19 males who were(60.56±3.89)years old.The 36 patients with AIS who took the medical team resource management mode at the emergency department from February 2021 to February 2022 were set as an observation group,including 16 females and 20 males who were(60.59±3.91)years old.The first aid efficiencies,neurological function,daily living ability,disability rates,quality of life,and patients'satisfaction degrees were compared between the two groups.t andχ^(2) tests were applied.Results The emergency triage time,emergency detention time,and time from treatment to thrombolysis in the observation group were shorter than those in the control group[(3.68±1.15)min vs.(5.09±1.23)min,(39.42±3.18)min vs.(46.24±3.25)min,and(55.23±5.40)min vs.(64.79±5.53)min;t=5.024,8.999,and 7.421;all P<0.001].The scores of National Institutes of Health Stroke Scale(NIHSS)and the Ability of Daily Living Scale(ADL)at discharge in the observation group lower than those in the control group[(6.51±1.50)vs.(8.93±1.54)and(21.35±2.16)vs.(25.50±2.19);t=6.754 and 8.095;both P<0.001].The disability rate in the observation group was lower than the that in the control group[2.78%(1/36)vs.16.67%(6/36);χ^(2)=3.956;P=0.047].The score of stroke quality of life scale(SS-QOL)at discharge in the observation group was higher than that in the control group[(140.84±6.83)vs.(119.92±6.64);t=13.177;P<0.001].The scores of first aid methods,safety management,humanistic care,and nursing attitude of satisfaction and the total score in the observation group were higher than those in the control group[(21.26±1.18)vs.(18.98±1.13),(21.85±1.23)vs.(19.94±1.20),(21.96±1.25)vs.(18.54±1.16),(21.80±1.43)vs.(19.06±1.30),and(84.43±3.34)vs.(75.54±3.26);t=8.373,6.669,12.033,8.507,and 11.429;all P<0.001].Conclusion Adopting the medical team resource management mode in the first aid green channel for patients with AIS can improve the efficiency of first aid and their neurological function,daily living ability,prognosis,and satisfaction degree.